Nutritional and anthropometric assessment of the scope for dietary optimization during staging prior to pancreaticoduodenectomy.

CONTEXT Although several studies have examined peri-operative nutritional supplementation in patients undergoing pancreaticoduodenectomy all provided support at various timepoints with a variety of protocols. OBJECTIVE This study undertakes a detailed nutritional and anthropometric assessment of patients due to undergo pancreaticoduodenectomy with particular reference to pre-operative nutritional status and peri-operative outcome. PATIENTS Twenty-six patients undergoing pancreaticoduodenectomy. SETTING A regional hepatobiliary service. MAIN OUTCOME MEASURES Nutritional, anthropometric and clinical course details. DESIGN Data were collected prospectively. RESULTS There was no significant change in any anthropometric index from baseline to immediately prior to surgery. However, there was a significant fall in BMI comparing baseline measurements to observations at time of discharge from hospital (P<0.001). There was, in addition, a significant difference between baseline and BMI at 3 months (P<0.001). Similar trends were observed in mid-arm circumference, triceps skin fold thickness and hand-grip. There was no in-hospital or 3-month post-operative mortality in this series. CONCLUSION Nutritional and anthropometric indices remain stable from the time of index admission to operation. However, there is a drastic and sustained reduction in nutritional indices in the post-operative period with this deficiency being sustained at 3-months after operation.